The present disclosure is generally related to image guided medical procedures using a surgical instrument, such as an optical scope, an optical coherence tomography (OCT) probe, a micro ultrasound transducer, an electronic sensor or stimulator, or an access port based surgery.
In the example of a port-based surgery, a surgeon or robotic surgical system may perform a surgical procedure involving tumor resection in which the residual tumor remaining after is minimized, while also minimizing the trauma to the intact white and grey matter of the brain. In such procedures, trauma may occur, for example, due to contact with the access port, stress to the brain matter, unintentional impact with surgical devices, and/or accidental resection of healthy tissue. A key to minimizing trauma is ensuring that the surgeon is aware of what is transpiring in the operating room, has a proper view of the surgical site of interest, and has proper control of the surgical positioning system without undue distraction.
FIG. 1 illustrates the insertion of an access port into a human brain, for providing access to internal brain tissue during a medical procedure. In FIG. 1, access port 12 is inserted into a human brain 10, providing access to internal brain tissue. Access port 12 may include such instruments as catheters, surgical probes, or cylindrical ports such as the NICO Brain Path. Surgical tools and instruments may then be inserted within the lumen of the access port in order to perform surgical, diagnostic or therapeutic procedures, such as resecting tumors as necessary. The present disclosure applies equally well to catheters, DBS needles, a biopsy procedure, and also to biopsies and/or catheters in other medical procedures performed on other parts of the body.
In the example of a port-based surgery, a straight or linear access port 12 is typically guided down a sulci path of the brain. Surgical instruments would then be inserted down the access port 12. Optical tracking systems, used in the medical procedure, track the position of a part of the instrument that is within line-of-site of the optical tracking camera. The surgical positioning system will often have a camera mounted thereon and is responsible for maintaining a view of the surgical site of interest by moving the camera to the proper positions, under the control of the surgeon.
During surgical procedures, a surgeon utilizing an external optical system may want or need to view the surgical site from multiple angles. A problem can occur if it takes a significant amount of time to achieve this or if the surgeon needs to remove tools from the surgical field to move the optical system between these different angles. In many cases, these viewing angles are known before the procedure or can all be defined at the start of the procedure.
Conventional systems have not offered good solutions for ensuring that a surgeon has a good view of the surgical site without constantly having to reconfigure the optical system positioning the camera. It would be desirable to have a system that helps a surgeon maintain the optical system in the appropriate positions without placing undue burden on the surgeon during the medical procedure.